Table 1.
Example Mobile WACh NEO SMS Based on IMB theory
| Construct | Day | Example messages |
| Information | ||
|
1 week before estimated due date | {name}, this is {nurse} from {clinic}. Did you know that newborns should be taken to the health facility if they stop breastfeeding well, develop a fever, are breathing fast or become less active? How will you get to your nearest health facility in case of an emergency? |
|
Day of delivery | {name}, this is {nurse} from {clinic}. Newborns need to be kept warm. The baby is wiped right after birth. Keep the baby bare skin-to-skin with you and cover you both. Dress the baby in socks, a nappy and hat. Place the baby on your naked chest and cover both of you. This contact helps with bonding, breastfeeding and keeps the baby warm. It is very important to avoid bathing your baby in the first 2 days. Do you have questions about keeping your baby warm or the bath? |
|
2 days post partum | {name}, this is {nurse} from {clinic}. Your milk should start to ‘come in’ between birth and day 5. Breastfeed your baby often, don’t skip breastfeedings (even at night), ensure good attachment/positioning, and let baby finish the first breast before offering the other side. To decrease discomfort from swollen breasts, use cold and/or cabbage leaf compresses between feedings. If baby is having trouble attaching to the breast properly during breastfeeding due to swollen breast, express milk from the swollen breast until the nipple is soft, then try putting the baby on the breast again. |
|
3 days post partum | {name}, this is {nurse} from {clinic}. Once the baby is born you can prevent infections by washing your hands and keeping the cord clean. Do not apply any substances or bandages to the cord. Do you have any questions about taking care of the baby’s umbilical cord? |
|
4 days post partum | {name}, this is {nurse} from {clinic}. Hold your baby skin-to-skin as much as possible throughout the day. This will help them grow. How is skin-to-skin holding/kangaroo care going for you and your baby? Also be sure to monitor the baby’s umbilical cord. Do not apply any substance or bandages to it but let us know if it is red or there is discharge. |
|
4 days post partum | {name}, this is {nurse} from {clinic}. Is the baby having any trouble breathing? Do they seem very hot or cold? These are danger signs and could mean the baby is sick. Please let us know right away. |
| Motivation | ||
|
10 weeks and 5 days before expected delivery date | {name}, this is {nurse} from {clinic}. Sometimes pregnancy and motherhood can bring on sadness, anxiety or worry. This happens to many women and can cause you to feel alone, cry and have difficulty sleeping. Are you having any of these problems? |
|
24 days post partum | {name}, this is {nurse} from {clinic}. How are you and the little one doing today? We know it is a new experience and some days are much difficult than others. You and the baby are learning and growing everyday. You are doing a good job and we are here to help with any advice you might need. Please SMS us with any concerns. |
|
28 days post partum | {name}, this is {nurse} from {clinic}. How are you doing today? We know you are doing your best and we want to thank you for all the good work you put into supporting your little one. Make sure you take a few minutes to appreciate your hard work and let us know if there are areas where you are experiencing difficulties such as feeding the baby, experiencing problems in sleeping or feeding, difficulties looking after or connecting with the baby, anxious or sad feelings coming up. We are here to help. Which of these difficulties are you having? |
| Behavioural skills | ||
|
13 and 6 days before estimated delivery date | (name), this is (nurse) from (clinic). Regular, strong stomach pains are a sign of labour. If you feel this strong tightening regularly pains, leaking of fluid or bleeding, go to the facility. Do you feel any contractions? Do you have any concerns? |
|
4 days before estimated delivery date | {name}, this is {nurse} from {clinic}. Even during this time of the COVID-19 epidemic, you still need to go to the clinic for antenatal and postnatal care. Coming to the clinic, including at delivery, is still very important for you and the baby. If you have mild symptoms of COVID-19 (cough, congestion, mild fever) and have a regularly scheduled visit, please stay home. If your symptoms become severe (high fever, difficulty breathing, chest pain or trouble doing your daily activities because of respiratory illness) please seek care for your illness. Do you have any questions or concerns about the COVID-19 virus? |
|
14 days post partum | {name}, this is {nurse} from {clinic}. By 2 weeks old a newborn baby may cry up to 2 hours a day. Make sure your baby is not hungry, tired or has a dirty diaper/nappy. Pay attention to what calms your baby like singing, rocking, swaddling or sucking. Does your baby cry for more than 30 min at a time? Please let us know when you are having any problems with your baby. |
|
16 days post partum | {name}, this is {nurse} from {clinic}. Getting to know your newborn and their schedule can be hard especially when you are not getting enough sleep. It is normal to feel tired and to need help. Do you have someone to help you or have concerns that maybe the nurse can help with? |
*COVID-19 messages developed based on Kenya Ministry of Health guidelines.69
IMB, Information-Motivation-Behaviour Skills; SMS, short messaging service; WACh, women’s and children’s health.